Indian health center promotes traditional food to fight diabetes

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Patricia Leigh Brown

To walk into the central gathering space of the Potawot Health Village in Arcata, a multi-tribal health clinic, is to be made instantly aware of the concept of traditional native food as medicine. “Got Acorns?” reads a poster. “Got salmon?” “Got seaweed?”

Built, administered and owned by American Indians, Potawot is at the front line of a national resurgence among native peoples to address the link between the loss of ancestral native foods and disproportionate rates of diabetes and other chronic diseases.

California is home to more American Indians and Alaska Natives than any other state, with 107 federally recognized tribes, making diabetes a major community health issue. The statistics are sobering: According to the Centers for Disease Control and Prevention, from 1994 to 2004, there was a 68 percent increase in diabetes among native youth ages 15 to 19 across the country and a doubling of the diabetes rate among those 35 and younger.

“We’re trying to re-establish the traditional ways we thought about food,” explained Paula “Pimm” Allen, the clinic’s traditional resource specialist, who comes from a long line of respected Yurok and Karuk healers and cultural practitioners. “Taking care of ourselves, our families, the community and the environment all are interconnected.”

Potawot Health Village opened in 2002 to serve Yurok, Tolowa, Wiyot, Hupa and Karuk Indians who live within in a 5,000-square-mile territory encompassing most of northern Humboldt and Del Norte counties. The village also has five satellite clinics, including one in Weitchpec, an isolated Yurok village along the Klamath River that has yet to receive electricity.

The village’s traditional redwood plank construction embodies its place as well as the connection between food, community and the environment. The complex is organized around a central “wellness garden” composed of native medicinal plants, fed by rainwater captured from roofs. It is all encircled by a 20-acre restored wetland, along with two miles of walking trails wending their way though a “basket garden” of native grasses used for weaving. A 2½-acre organic nutritional garden and orchard supplies produce for the clinic’s seasonal farmers market, where native cooking demonstrations are part of the repertoire.

Cultural traditions are a route to healing, Allen explained.

“We were forcibly disconnected from our food, just as we were with our language and our culture,” she said. “People who are connected to community are more likely to take care of themselves.”

Potawot was one of 17 Indian organizations nationwide chosen to receive a $100,000 grant from the CDC’s Native Diabetes Wellness Program. The clinic is using the money to develop a comprehensive Food as Medicine program for patients. In conceptualizing the grants, the CDC conferred with tribal leaders.

“They said culture is the source of health,” said Dawn Satterfield, team leader of the wellness program at the CDC’s Division of Diabetes Translation. “They made that connection very clear.”

Although the reasons for the devastating impact of the disease on American Indians are complex, many experts believe that historical trauma – including the forced abandonment of traditional practices and native habitat – have been contributing factors.

Mariana Leal Ferreira, a medical anthropologist and associate professor at San Francisco State University, said government policies – such as forcibly taking children from their homes and placing them in boarding schools – had deleterious, long-term effects. Children were taught to abandon native language and culture, wrenching entire generations away from skills like hunting, fishing and gathering.

Over time, Ferreira said, it made families more susceptible to stress, setting up an overly reactive autonomic nervous system, which in turn can raise blood sugar levels in the body. Government-supplied commodities such as white flour and lard, along with a more sedentary lifestyle, also adversely affected health. The latest research shows that networks of social support and a strong cultural identity “can be protective factors that make people less vulnerable,” Ferreira said.

The Yurok lands along the Klamath River are a part of California that feels more like the Pacific Northwest. In this remote corner of the state, Gold Rush massacres and federal policies opening up native lands to settlers have been echoed in more recent history by hydroelectric dams, which depleted water levels and salmon populations, and timber harvesting on ceremonial lands.

In Northern California and elsewhere, access to native foods has become both an environmental and human rights issue. Karuk elders recall eating salmon three times a day. They also relied on eel, freshwater mussels, Indian rhubarb and acorns to which they now have limited access, said Kari Marie Norgaard, a sociologist at the University of Oregon.

“Every native tribe has a story about what happened to their food system,” said Kibbe Conti, a native dietitian and a nutritionist at the Indian Health Service Hospital in Rapid City, S.D. In the northern Great Plains, for instance, the Sioux hunted for buffalo, fished and collected wild rice. After reservations were established, however, they grew dependent on flour, salt pork, low-grade beef and pork, sugar, and other government rations.

As an alternative to the classic American food pyramid, Conti has developed a nutritional “medicine wheel” that emphasizes traditional lean protein like bison and once-primary beverages like fresh water and tea.

“We’re not going to completely rebuild the traditional food system,” Conti said. “But there is wisdom there we can apply.”

Joy Sundberg, a 79-year-old resident of Trinidad Rancheria and a Potawot board member, recalls when the skies over Humboldt and Del Norte counties “were black with ducks,” she said.

“When I was young, it was disgraceful to be fat,” she continued. “We always had deer, and smoked salmon was a staple. There were acorns and fish and berries for every season.”

Everything changed within her lifetime. Slim and vivacious, Sundberg is nevertheless dealing with diabetes. “You’ve got a McDonald’s here and a Hooters there,” she said. “It’s like Mothers Against Drunk Driving; it’s going to take dedication to change.”

At Potawot, about 500 schoolchildren a year visit the demonstration garden to learn about traditional food ways and healthier eating habits. Allen and her colleagues are working on adapting ancestral foods to contemporary life, emphasizing healthy organic foods that can be found at the supermarket, such as grass-fed beef and sustainably harvested fish.

They join a native food movement with considerable momentum. In Minnesota, for instance, the White Earth Land Recovery Project’s Mino-Miijim Program delivers buffalo meat, hominy, wild rice and other native foods to isolated Ojibwe elders. Indian rights activist and writer Winona LaDuke started the project to buy White Earth Reservation property in northern Minnesota that was privately held. To aid economic development, the group set up a website, Native Harvest, to sell locally grown organic food and handicrafts.

The Confederated Tribes of the Umatilla Indian Reservation, on the Columbia River plateau in eastern Oregon, have forged new approaches to land management, adopting a conservation strategy to protect and restore “first foods,” including salmon, deer and huckleberries.

Dr. Elizabeth Topsky, a family physician at the Jemez Pueblo in New Mexico, notes that poverty continues to play a major role in the diabetes equation. On the Jemez reservation, she said, the only local source of vegetables is the cooler at a gas station convenience store.

“Coming from a poverty background myself, I can remember not having enough food,” said Topsky, a board member of the Association of American Indian Physicians. “So I have a different outlook than my children. We were always told to finish our food – because we had it,” she said.

The tribe recently started a farm-to-school garden program at several local elementary schools.

Allen, at the Potawot Health Village, recently was diagnosed with diabetes herself. She notes that bad food choices often reflect the day-to-day pressures on families, especially in a down economy. “As a parent, you’re stressed out, trying to get the bills paid,” she said. “Do you buy cauliflower for $6 and cook for an hour? Or zap something in the microwave for 99 cents?”

To Allen, making healthier decisions, including growing fruits and vegetables in the backyard, is an embrace of both culture and wellness. “We are trying to make people aware that food comes from people and places,” she said. “We need to be eating food that represents our values.”